成瀬 寛之

Background: Studies outside Japan have linked sugar-sweetened beverage (SSB) intake with weight gain; however, evidence in Japanese adults is scarce, and no study has examined beverage-derived energy in relation to anthropometric indices and handgrip strength. Methods: The participants were employees of Fujita Health University aged 20-39 years (n = 76; male n = 35, average age: 29.97 ± 4.67 years; female n = 41, average age: 27.29 ± 4.53 years). Energy from beverage intake was assessed via the Brief Beverage Intake Questionnaire-15, and energy from alcoholic drinks, milk, SSBs, and total beverages was calculated. The associations of energy from different beverages with nutrient intake, BMI, skeletal muscle mass index (SMI), and handgrip strength were analyzed via ordinary least squares (OLS) regression; quantile regression (QR) and the generalized additive model (GAM) were used for sensitivity analyses. Results: Increased SSB intake was associated with increased BMI (standardized β = 0.35, 95% CI 0.12-0.58, p(OLS) < 0.001; p(QR) = 0.23; p(GAM) < 0.001) and was nonlinearly associated with increased SMI (standardized β = 0.21, 95% CI 0.043-0.37, p(OLS) = 0.02; p(QR) = 0.11; p(GAM) = 0.02), even after adjustment for total energy intake. Modest milk intake was linked to higher protein intake and a higher SMI without a higher BMI (standardized β = 0.18, 95% CI 0.020-0.35, p(OLS) = 0.03; p(QR) = 0.39; p(GAM) = 0.03). Conclusions: A positive association was found between SSB intake and both BMI and SMI and between MILK intake and SMI. Clarification in larger, diverse Japanese populations will be necessary.

Background and Aim: Underweight young adult women are vulnerable to health risks such as menstrual disorders and vitamin deficiencies. Because few seek medical care for low body weight, the underlying causes remain unclear. This study aimed to examine the associations of body type with dietary patterns and gut microbiota diversity in young women. Methods: We enrolled 40 women aged 20–39 years who visited a nutrition evaluation clinic with a BMI &lt; 17.5 at their first consultation (underweight group) and 40 age-matched women with 18.5 ≤ BMI &lt; 25 (control group). Some women in the underweight group were no longer underweight at the time of analysis but were classified based on their initial BMI. Dietary patterns were assessed based on ten major food categories (meat, fish, eggs, dairy products, soybeans, green and yellow vegetables, seaweed, fruit, tubers, and fats and oil) based on the Food Frequency Questionnaire based on Food Groups. Gut microbiota α-diversity was evaluated using the Shannon, Simpson, and Pielou indices, while β-diversity was analyzed by nonmetric multidimensional scaling (NMDS) and redundancy analysis (RDA). Genera contributing to group differences were identified by RDA and ANOVA-Like Differential Expression tool (ALDEx2). Results: Underweight women had significantly lower gut microbiota α-diversity, while no difference was observed in dietary pattern scores. NMDS revealed significant β-diversity differences in gut microbiota (PERMANOVA: R2 = 0.064, F = 5.31, p = 0.0001) but not in dietary patterns (p = 0.99). RDA showed that body type explained 4.5% of variance (adjusted R2 = 0.032, F = 3.65, p = 0.0005). Bacteroides, Bifidobacterium, Enterocloster, and Erysipelatoclostridium were enriched in underweight women, whereas Fusicatenibacter, Agathobacter, Dorea, and Prevotella were enriched in controls. AldEx2 confirmed increases in Bacteroides, Enterocloster, and Erysipelatoclostridium and a decrease in Dorea. Conclusions: Underweight women demonstrated reduced gut microbiota diversity and enrichment of taxa associated with inflammatory tendencies. Dietary therapies involving not only prebiotics but also probiotics may beneficially modulate gut microbiota and contribute to the management of low body weight.

Background/Objectives: Dietary patterns vary with age and sex. The aim of this study was to clarify the differences in dietary patterns among young and middle-aged Japanese individuals by age group and sex via statistical methods such as alpha diversity and beta diversity analyses. Methods: Using data from a dietary survey of 10 food items during health checkups of 2743 Fujita Health University employees, we examined the effects of age and sex on alpha diversity (Shannon index) and beta diversity (nonmetric multidimensional scaling (NMDS) and RDA). Unlike principal component analysis which assumes linear relationships, redundancy analysis (RDA) incorporates explanatory variables to directly assess how external factors shape multivariate patterns. Results: The Shannon index increased with age and was greater in males across age groups. Type III ANOVA revealed significant main effects of age (p &lt; 0.001) and sex (p &lt; 0.001), and the effect of the interaction between age and sex approached significance (p = 0.08). Visualization of the NMDS data revealed that women aged 20–29 years and women aged 30 years and older and men aged 20–39 years and men aged 50–59 years have different dietary patterns. The RDA model accounted for 2.01% of the variance (adjusted R2 = 1.94%), with age and sex contributing 56.7% and 43.3%, respectively. RDA1 and RDA2 were correlated with age (r = 0.26, −0.14) and sex (r = 0.15, 0.21). The RDA1 values increased with age and were greater in females, whereas the RDA2 values decreased with age and were greater in females. RDA1 (1.41% of the total variance in food group intake, 70.1% of the constrained variance) was positively associated with fruits, milk, and seaweed and negatively associated with meat and eggs. In RDA2 (0.60% of total variance, 29.9% contribution), fruits, potatoes, and vegetables had positive effects, whereas fish had negative effects. Conclusions: Dietary patterns vary by age and sex, with meat, fish, eggs, and fruit as key determinants. Nutritional guidance must account for variations in dietary patterns influenced by age and sex.

BACKGROUND: Sarcoidosis is a systemic granulomatous disease that occasionally affects the heart and poses the risks of arrhythmias, heart failure, and sudden cardiac death. CASE SUMMARY: We report a rare case of cardiac sarcoidosis presenting as a large intracardiac mass in a 76-year-old woman that was incidentally detected during a health check-up. Transthoracic echocardiography revealed a 25× 33 mm mobile mass in the left atrium. Cardiac magnetic resonance and 18F-fluorodeoxyglucose positron emission tomography/computed tomography demonstrated heterogeneous enhancement and increased metabolic activity, respectively, raising the suspicion of cardiac sarcoidosis. Bronchoscopic biopsy confirmed the presence of epithelioid granulomas, supporting the diagnosis. Surgical resection was performed because of the size of the mass and the potential for mitral valve obstruction. Histopathology confirmed the presence of non-caseating granulomas consistent with sarcoidosis. Postoperatively, corticosteroid therapy with prednisolone (initially 30 mg/day, tapered to 5 mg/day) was initiated to treat the residual lesions identified on imaging. The residual mass showed regression, with resolution of inflammatory activity, through the use of steroid therapy during follow-up. DISCUSSION: This case report highlights the diagnostic and therapeutic challenges associated with cardiac sarcoidosis presenting as a large intracardiac mass. Our findings underscore the importance of a multidisciplinary approach that utilises advanced imaging techniques, histological confirmation, and tailored management strategies that combine surgical intervention and immunosuppressive therapy for diagnosis and treatment.